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SHANNON WALLACE FNP-C
NPI 1992699326
Nurse Practitioner - Family in Buffalo, MO

Active since June 09, 2025PECOS Enrolled
201 S ASH ST, BUFFALO, MO 65622(417) 325-6000 Get Directions Write a Review

NPPES record last updated: June 9, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Shannon Wallace Fnp-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHANNON WALLACE FNP-C (NPI 1992699326) is an individual family provider in Buffalo, Missouri, licensed in Missouri (2025020699) and active in the NPI registry since June 2025. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1992699326
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameSHANNON WALLACECredential: FNP-C
Location Address201 S ASH STBuffalo, MO 65622-8674
Mailing Address21350 County Road 401Urbana, MO 65767-8576 · (620) 288-0416
Phone(417) 325-6000
Sole ProprietorNo
Enumeration DateJune 9, 2025
NPPES CertifiedJune 9, 2025
✔ NPI 1992699326 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in MO · 2025020699
201 S ASH ST, Buffalo, MO 65622
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Cox HealthPlans, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shannon Wallace Fnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Shannon Wallace reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Citizens Memorial Healthcare
18 mi
Surgery
1500 N OAKLAND AVE
Bolivar, MO 65613
  • Reassigned Medicare billing, Missouri enrollment
  • 249 clinicians in this Medicare group
NPI 1568566131 (417) 326-6000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 65622 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.64 typical visit price
range $52.28 – $161.24
Typical copayment $20.41 (range $13.07 – $40.31)
Most-billed visit code 99203
Established Patient
$93.24 typical visit price
range $16.30 – $131.05
Typical copayment $23.31 (range $4.07 – $32.76)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. TAYLOR NICOLE PEDERSEN DO
Family Medicine
201 S ASH ST
BUFFALO, MO 65622
Dallas County (417) 345-4858
LINZI SMITH FNP
Nurse Practitioner (Family)
201 S ASH ST
BUFFALO, MO 65622
Dallas County (417) 345-6100
BROOKLYN EWBANK LMSW
Social Worker
201 S ASH ST
BUFFALO, MO 65622
Dallas County (417) 345-6100
RONALD DAVID HUNZIGER FNP-BC
Nurse Practitioner (Family)
201 S ASH ST
BUFFALO, MO 65622
Dallas County (417) 345-6100
MRS. KIMBERLY D FERRELL LPC
Counselor (Professional)
201 S ASH ST
BUFFALO, MO 65622
Dallas County (417) 345-6100
CITIZENS MEMORIAL HEALTHCARE
Clinic/Center (Rural Health)
201 S ASH ST
BUFFALO, MO 65622
Dallas County (417) 345-6100
SARA E HERTZKE-HILL PA-C
Physician Assistant
201 S ASH ST
BUFFALO, MO 65622
Dallas County (417) 345-6100
DR. KURT RUSSELL BRAVATA M.D.
General Practice
201 S ASH ST
BUFFALO, MO 65622
Dallas County (417) 345-6100

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shannon Wallace's NPI number?

The NPI number for Shannon Wallace is 1992699326. It was assigned to this individual provider in the NPPES registry on June 9, 2025.

Where is Shannon Wallace located?

Shannon Wallace practices at 201 S Ash St, Buffalo, MO 65622. The listed phone number is (417) 325-6000.

What is Shannon Wallace's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Shannon Wallace enrolled in Medicare?

Yes. Shannon Wallace is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Shannon Wallace's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shannon Wallace reassigns Medicare benefits to Citizens Memorial Healthcare (Bolivar, MO). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shannon Wallace's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Shannon Wallace accept?

Health plans from Anthem Blue Cross and Blue Shield, Cox HealthPlans and UnitedHealthcare list Shannon Wallace as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Shannon Wallace was last updated on June 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.